Increased left ventricular end diastolic volume is seen in:

Correct Answer: A

Rationale: In pediatric nursing, understanding cardiovascular conditions is crucial for providing quality care to young patients. In this context, the correct answer to the question, "Increased left ventricular end diastolic volume is seen in mitral regurgitation," is A. Mitral regurgitation results in blood leaking back into the left atrium during systole, leading to increased volume in the left ventricle during diastole. This increased volume is reflected as an elevated left ventricular end-diastolic volume, a hallmark feature of mitral regurgitation. Option B, congestive cardiomyopathy, is characterized by impaired ventricular function leading to decreased cardiac output and volume overload. This condition would not typically present with an increased left ventricular end-diastolic volume. Option C, hypertrophic obstructive cardiomyopathy, is characterized by left ventricular hypertrophy and outflow tract obstruction, which would not directly result in an increased left ventricular end-diastolic volume. Option D, aortic stenosis, is characterized by obstruction of blood flow during systole, leading to increased left ventricular pressure but not necessarily an increased end-diastolic volume. Understanding these distinctions is essential for nurses caring for pediatric patients with cardiovascular conditions, as it guides appropriate assessment, intervention, and monitoring to optimize patient outcomes.

Correct Answer: C

Rationale: In pediatric nursing and pharmacology, understanding the differences between renal tubular acidosis (RTA) type II and type I is crucial for providing safe and effective care to pediatric patients. The correct answer, Option C, states that urinary pH can be lowered < 5.5 in an ammonium chloride loading test in type I RTA. This is correct because in type I RTA, there is a defect in the distal tubule resulting in impaired acid secretion, leading to a low urinary pH in response to an acid load. Now, let's discuss why the other options are incorrect: - Option A, Increased anion gap, is not a feature that differentiates type II from type I RTA. An increased anion gap is typically seen in conditions like metabolic acidosis but is not specific to either type of RTA. - Option B, Nephrocalcinosis, is a feature commonly associated with type I RTA, not type II. Nephrocalcinosis is the deposition of calcium salts in the renal parenchyma, often seen in patients with type I RTA due to impaired acid excretion. - Option D, Aminoaciduria, is not a distinguishing feature between type II and type I RTA. Aminoaciduria is the presence of amino acids in the urine and can be seen in various renal conditions but is not specific to either type of RTA. Understanding these distinctions is vital for nurses caring for pediatric patients with RTA as it impacts their assessment, treatment, and overall management. By grasping the unique characteristics of each type of RTA, nurses can provide more individualized care and monitor for potential complications more effectively.

Correct Answer: A

Rationale: In the context of pediatric pharmacology, understanding X-linked conditions is crucial for providing safe and effective care to pediatric patients. In this specific question, the correct answer is A) Duchenne muscular dystrophy. Duchenne muscular dystrophy is an X-linked recessive disorder, meaning the gene responsible for this condition is located on the X chromosome. Males are more commonly affected by X-linked recessive disorders because they have only one X chromosome, while females have two X chromosomes which can potentially mask the effects of the mutated gene. Hypophosphataemic rickets is inherited in an X-linked dominant manner, so it is not the correct answer in this case. Huntington's chorea is an autosomal dominant disorder, unrelated to X-linked conditions. Phenylketonuria is an autosomal recessive disorder, not an X-linked condition. Educationally, understanding the inheritance patterns of genetic disorders is essential for nurses caring for pediatric patients. Recognizing X-linked conditions helps in genetic counseling, family education, and anticipating potential health issues in children. This knowledge also informs medication choices and potential side effects based on the patient's genetic predispositions.

Correct Answer: B

Rationale: In pediatric nursing, understanding the features of severe folate deficiency is crucial for providing quality care to pediatric patients. In this case, the correct answer is B) Glossitis. Glossitis, which is inflammation of the tongue, is a common manifestation of severe folate deficiency due to its role in cell growth and division, especially in rapidly dividing tissues like the oral mucosa. This symptom can present as a swollen, smooth, red, and painful tongue in affected individuals. Option A) Steatorrhea is incorrect because it refers to the presence of excess fat in the stool, which is more commonly associated with malabsorption issues rather than folate deficiency. Option C) Leucoerythroblastic picture typically indicates bone marrow pathology, such as infiltration or fibrosis, rather than folate deficiency. Option D) Increased total iron binding capacity is more indicative of iron deficiency anemia rather than folate deficiency. Educationally, understanding the specific clinical manifestations of nutrient deficiencies in pediatric patients is essential for early identification and intervention. By recognizing the signs and symptoms associated with folate deficiency, nurses can advocate for appropriate diagnostic testing and nutritional interventions to improve pediatric patients' health outcomes.

Correct Answer: B

Rationale: In congenital hypertrophic pyloric stenosis (CHPS), the correct answer is B) Hypokalaemia is due to vomiting. This condition is characterized by an obstruction at the pyloric sphincter, leading to projectile vomiting. The continuous loss of stomach contents causes metabolic alkalosis and dehydration, leading to hypokalemia due to the loss of potassium in vomitus. Option A) Conjugated hyperbilirubinemia is not typically seen in CHPS. This finding is more commonly associated with conditions like biliary atresia or liver disease. Option C) The statement that blood pH is high and urinary pH is low is not accurate for CHPS. In this condition, metabolic alkalosis can occur due to vomiting, leading to an elevated blood pH and compensatory low urinary pH. Option D) While CHPS can occur in first-born males, it is not a defining characteristic of the condition. CHPS can affect both males and females, regardless of birth order. Educationally, understanding the pathophysiology of CHPS is crucial for pediatric nurses. Recognizing the signs and symptoms, such as projectile vomiting and electrolyte imbalances like hypokalemia, allows for prompt diagnosis and intervention. This knowledge is essential for providing safe and effective care to pediatric patients with CHPS.